Receiving a biomarker report full of numbers and reference ranges can feel overwhelming. Most people either dismiss values that are technically "in range" but far from optimal, or misinterpret minor deviations as urgent problems. This guide helps you read your results accurately, identify what needs attention, and prepare for a productive clinician conversation.
Understanding Reference Ranges
Every value on your report will show a result alongside a reference range (e.g., 300–1,000 ng/dL for testosterone). Three things to understand:
- In range ≠ optimal: Being technically within the reference range does not mean your levels are at the best level for you personally. The range is broad by design.
- Slightly out of range ≠ urgent: A value just below or above the reference range may or may not require immediate action — context and symptoms matter.
- Trends matter more than single values: A testosterone level that has dropped 200 ng/dL over three years — even if still "normal" — tells a different story than stable levels.
How to Review Your Results Systematically
Step 1: Check for Flagged Values
Lab reports typically flag values that fall outside the reference range with "H" (high) or "L" (low) indicators. Start by noting any flagged values — these are the priorities for your clinician review.
Step 2: Look at Hormone Markers Together
Hormones do not operate independently. Read related markers as a group:
- Total testosterone + free testosterone + SHBG together
- LH + FSH + total testosterone together (helps identify the cause of any deficiency)
- Testosterone + estradiol together (the aromatization relationship)
- TSH alone, or with T3/T4 if ordered
Step 3: Check Safety Markers
For anyone considering or already on hormone therapy, pay specific attention to:
- Hematocrit (target <50% for TRT safety)
- PSA (baseline establishment; significant change warrants evaluation)
- Liver enzymes (ALT, AST) — should be within normal range
- Lipids — LDL, HDL, triglycerides
Step 4: Note Your Symptoms Alongside Your Results
Before your clinician consultation, write down: your main symptoms, how long you have had them, and any changes you have noticed over time. A testosterone of 320 ng/dL means more in the context of "severe fatigue, low libido, and weight gain for 18 months" than in isolation.
Values That Typically Warrant Prompt Clinician Review
| Marker | Value Warranting Prompt Review | Potential Significance |
|---|---|---|
| PSA | >4.0 ng/mL, or rapid rise | Prostate health evaluation needed |
| Hematocrit | >52% | Elevated clotting risk (especially on TRT) |
| Prolactin | Significantly elevated | Possible pituitary adenoma — MRI evaluation |
| TSH | >4.5 or <0.4 mIU/L | Thyroid dysfunction |
| ALT/AST | >2–3× upper limit of normal | Liver stress — medication review needed |
Preparing for Your Clinician Consultation
To get maximum value from a lab review consultation:
- Have your results open and ready to share or reference
- Know your current medications and any supplements
- Be specific about your symptoms — frequency, severity, and duration
- Bring any prior lab results you have for trend comparison
- Write down your top 2–3 questions in advance so you do not forget them
Frequently Asked Questions
My results are in range but I still feel terrible. What should I do?
This is common with hormone biomarkers. "Normal range" does not mean optimal for you — and functional optimization often requires getting your values to the upper-middle portion of the normal range rather than just above the floor. Discuss this specifically with your clinician, citing your symptoms and how long you have had them.
Do I need to fast before a biomarker test?
It depends on which markers are included. Lipid panels, fasting glucose, and insulin require fasting (typically 8–12 hours). Hormone markers like testosterone do not require fasting but should be collected in the morning (before 10 AM) for accuracy. Your test kit instructions will specify requirements for your particular panel.
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